Provider Demographics
NPI:1376763185
Name:PURSER, DANNY CLINTON (MD)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:CLINTON
Last Name:PURSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 CHEROKEE LANE
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604
Mailing Address - Country:US
Mailing Address - Phone:801-427-9733
Mailing Address - Fax:801-377-0806
Practice Address - Street 1:383 W 600 N
Practice Address - Street 2:
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042-1330
Practice Address - Country:US
Practice Address - Phone:801-796-7667
Practice Address - Fax:801-785-8805
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1741241205208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice